Community Health Screening Request Form

Thank you for your interest in our health screening services. If you have questions about scheduling an event, please contact the Center for Health Promotion and Disease Prevention at (313) 874-3095.

* Asterisk indicates required field.

Today's Date
*
*
*
*
*
*
Event information
Desired date of event (must be at least six weeks out)
*
*
*
*
*
*
Health Screening Services

Please note: Participants must be 18+ years old

Check all that apply


 

Schedule Appointment Online

Please call 911 if you have an emergency or urgent medical question.

Already a Henry Ford patient?
For the best experience, existing Henry Ford patients can request and self-schedule appointments through Henry Ford MyChart.

Henry Ford Health System is committed to ensuring our Deaf or hard-of-hearing patients and visitors have equal access to all services. We provide the appropriate auxiliary aids and services, including qualified sign language interpreters, TTYs and other assistive listening devices, at no cost. To request assistance, call 313-916-1896 or email [email protected].

Schedule Appointment for